Republished from Health Workers United.

• The various trade unions in the NHS started sending emails to their members to ask them whether to accept or reject the 3% pay offer from the government and whether to take industrial action or not. These consultations end at different times: RCN on the 13th of September; UNISON on the 10th of September; GMB on the 17th of September, Unite on the 24th of September etc.

• Sending out emails to individual members is not enough. Sitting alone at home, asked to vote ‘yes or no’, doesn’t make us feel strong. It also doesn’t reach our co-workers who are not union members – who are the majority. We need assemblies and rallies of all hospital or community ward workers, where we can see each other, give each other courage, discuss what to do. If the unions are not calling for such joint assemblies, we have to organise them ourselves.

• We have to talk about the different kind of problems we have at work and that we want to deal with. Pay is one issue amongst others. The daily stress due to lack of staff is a big one! They push more and more work on to us, from increased documentation to extra patients. This is frustrating for us and the patients, as well.

• We need to discuss how we can put pressure on management and the government. There are all kind of ways to organise a strike in hospitals without endangering patients’ lives. There are various actions that can put pressure on politicians, from occupying public administration to blocking roads. Petitions alone won’t impress them.

• We need independent channels to inform each other what is happening in different trusts across the country. This online newsletter is only one of many ways how we can exchange experiences about the pay campaign, about what the various unions are doing and what not, about what kind of actions we could all take together in order to change things. Feel free to send this newsletters to colleagues and friends and to send your own thoughts and observations.

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* Senior health care assistant, maternity unit, Bradford

Working during Covid was demanding, we had to improvise a lot due to staff shortage. When the government then announced the 1% pay offer people were pretty demoralised, many skilled midwives leave the field. They leave because usually the unions don’t promote going on strike. I have been working here 30 years and we never went on strike. I am not in the union anymore, I was a shop-steward, but I felt the union was more with management than with the workers. Now with the RCN things have improved a bit, but things are still difficult.

My colleagues talk about the pay offer a lot and would be up for industrial actions, but they worry about the consequences. As a form of industrial action you could refuse to fill out certain paper-work while still providing care, but then they tell us that legally you are obliged to do the documentation. It’s hard, we are not making sausages, we care for people. On maternity wards especially it is difficult to do just ‘minimum service’. Workers here are stressed out. Management currently offers a 40% bonus if midwives take up bank shifts, but they don’t do it, because they are over-worked, but also because they feel under-valued and just don’t want to work extra-shifts. We would need an action all over the trust.

* Collective sick-out at (private) Helios hospital in Germany – In reaction to systematic understaffing

Since the beginning of June, management has allowed the admission of more and more patients to the hospital. Patients spent hours sitting in corridors, waiting for beds to become available. The nurse per patient ratio reached from 1:20 to peaks of 1:30. Despite an increase of sickness-related absence of nurses and other health workers, management refused to cap the numbers of admitted patients. Apprentices and support staff had to take over tasks they had not been trained for, such as supervising monitors with patients’ vital signals.

End of July the situation escalated and a whole ward shift called in sick for three consecutive days. Patients had to be relocated to ICU and A&E. Only that moved management to officially declare that the hospital had reached its capacity limit. Surgeries had to be postponed. Management was aware that this was the result of a collective action, and workers celebrated this, even in those departments that had to deal with the relocated patients.

For the time being management has limited the amount of patients per ward, e.g. in cardiology there are currently 25 instead of 53 beds. Management has threatened individual workers with job transferals, but they have to acknowledge that the problem is not going away and that they have to do something about staffing levels. Without the workers, no patients and no money…

* Health worker, Southmead hospital, Bristol

Staffing levels are a major problem. Often you end up having four nurses and three HCAs looking after 33 patients who often actually require 1:1. This is hard as it is, but then the housekeeper is off and they can’t get a bank replacement. We are then expected to do that work on top of our work load. People are rushed into jobs without the proper training, because they don’t have enough staff to do the supernumerary shifts.

Management knows about the problem. For July and August they offer bonus payments for anyone who takes up extra bank shifts. For example, Band 2 are paid £21.05 per hour, Band 5 are paid £31.44. Regarding the pay campaign we had a protest here in Bristol organised by the NHS15 campaign, but most unions were not present, also only very few health workers. The campaign is not visible in the hospital.

* NHS social worker, south east England

How do you feel about the fair pay for NHS workers campaigns?

There are other issues I care more about but I’m broadly supportive of all industrial organising within the NHS.

What do think could help more [social] workers feel able to get involved and show support?

Appealing for more solidarity across the whole workforce. Finding shared areas of concern with social workers and offering reciprocity. Meeting with social work union representatives to formally invite them to get involved and to discuss how this might happen in practical terms. Framing this as a struggle for social justice more widely i.e. by showing the impact of unfair pay on the most precarious members of the NHS workforce & emphasising how this campaign is also protecting the interests of patients who depend on publicly funded healthcare.

Are there any changes you’d love to see in your workplace that aren’t pay related?

Changes to the terms of employment may help to make the workplace more privately bearable in the short term but in my opinion the bigger problem is the alienation from their own labour that so many NHS workers and their patients have come to feel is normal. The changes that I would like to see happening would be seeking to create and protect the possibility for non-alienated care labour within the NHS.

Could you spell the ‘alienation’ or ‘non-alienated labour’ out a bit more?

By alienated labour, I’m talking about what can happen when healthcare work is organised so much around the strategic priorities of NHS England that nothing else seems to matter. One of the consequences of this for frontline workers is that they can easily be made to feel that their labour only has value insofar as it is helping to smooth the way for agendas that have nothing to do with them. The alienation comes from the corresponding (unspoken) requirement that they should not care so much about what they are doing because this makes it more difficult for them to put the interests of their organisation first. This means that workers are withdrawing their affective investments in their own labour at the point that they don’t coincide with the interests of NHS England.

By non-alienated labour, I mean the kind of healthcare labour that doesn’t leave you feeling isolated and overwhelmed with the consequences of having a stake in it. For example, where the realities of healthcare in the NHS are not made into the private concern of individual workers, where workers are not required to do things that don’t make sense to them and where the task of organising healthcare labour is not left to those who won’t be directly involved in doing the work themselves.

* Health workers struggles around the world

During the last two weeks nurses went on strike in Kinshasa and Harare; nurses protested against arbitrary redundancies in Caracas and Hyderabad; hospital workers called for strike in Marseille and Lyon to protest against the government’s Covid laws; in Guatemala health workers joined the general strike; Covid support workers went on strike in Pakistan due to unpaid wages; in Germany and on the Bahamas nurses went on a collective sick-out; and in the USA and New Zealand workers have been on strike at various hospitals and nursing homes…

…so let’s not let them make us believe that health workers cannot take industrial action! For these news and many more follow us on Twitter: healthworkersu1